A recent study just co-released by the U.S. Department of Justice and the Department of Health and Human Services states that some 5 million Americans endure some form of elder abuse annually. This definition includes physical or mental abuse, neglect or financial exploitation. The study notes that 1 in every 10 people over the age of 60 living at home suffers some form of abuse, neglect or exploitation, but that most families never report elder abuse to the authorities. Actually the figure is astounding: only 1 family in 24 do report, according to the study.  It’s easy enough to report elder abuse, all you have to do is dial:  1-800-96-Abuse. So why aren’t more cases of elder abuse reported? Other questions begging for answers are what are the signs of elder abuse and who is most at risk?

The National Center on Elder Abuse says that contrary to popular belief, older adults are more likely to suffer abuse at the hands of their own family members acting as caregivers than by a paid caregiver, and echoes that only 4% of the instances of abuse are reported to authorities. Doesn’t it seem strange that more cases of abuse are not reported to the very authorities that are capable of stopping the abusers? There are many reasons. First, elders themselves often suffer shame and feel embarrassed to admit being taken advantage of by someone close, and someone they really trusted. They hesitate if it is a son, daughter or grandchild. Second, they are fearful of retaliation. Many times they will talk about it but don’t want to take any action. Third, a son or daughter may not want to get a sibling or relative in trouble by contacting Adult Protective Services (APS).  It takes courage to report an abusive family member to law enforcement. In short, seniors are fearful and loyal to their caregivers, even willing to accept blame, while family members are reluctant to point fingers at each other. Unfortunately, there is little advocacy for vulnerable elders. So how does someone on the outside recognize the red flags and how do you speak up if you suspect of elder abuse?

Sometimes it’s as simple as a senior giving a child or a grandchild a big loan they have no intention of ever paying back. Is taking a “loan” from an 80 year old and not paying it back elder abuse??? It should be reported to APS, but most grandmothers probably don’t want to see a grandchild go to jail.  Scenarios like this may be why elder abuse does not get reported and prosecuted more often, even when the family is well aware of the wrongdoing.  The victims refuse to testify against a relative who has taken advantage of them, suffering abuse or impoverishment rather than be the one to contact the authorities. Prominent Palm Beach County Elder Law Attorney Anné Desormier – Cartwright says: “Charges may not stick when the victim is unwilling to testify. Hard evidence and independent records are needed to prove the case in court.”

Abuse is not always financial. It may be physical, mental, emotional, sexual, or neglect by a caregiver. A caregiver may be a family member, an in-home paid worker, the staff person at an adult day care center or of a facility such as a nursing home. Anné Desormier – Cartwright explains that, “Unfortunately the older someone is, the greater the risk for abuse.”

Those most at risk for elder abuse include:

  •   ~  Older men just as much as older women, but the abuse is less frequently reported
  •   ~  Seniors or elders who are physically frail or disabled or suffering from cognitive decline like dementia, and are confused, disoriented, or mentally impaired

Causes contributing to high risk of abuse include:

  •   ~  Alcohol, medication, or drug abuse by the senior
  •  ~ Senior or elder behavior that includes verbal outbursts, incontinence, wandering, agitation, ungratefulness, overly-demanding and/or unpleasant demeanor

Red Flags that might be indicative of physical abuse include:

  •   ~  Cuts, puncture wounds, burns, bruises, welts, fractures, bedsores
  •   ~  Dehydration or malnutrition, poor coloration, sunken eyes or cheeks
  •   ~  Lack of hygiene, soiled or inadequate clothing or bedclothes, unsanitary conditions
  •   ~  Lack of medical aids like glasses, walker, dentures, hearing aid
  •   ~  Mis-managed medication, medication not being taken regularly or in correct dosage
  •   ~ Living space with inadequate light, heat, or cooling; health or fire and safety hazards, rodents or insects, open space heaters, broken plumbing, no water or electricity
  •   ~  Senior or elder is restrained in some way

Behavioral signs of abuse might include:

  •   ~  Fear, nervousness, anxiety, agitation
  •   ~  Anger, isolation, withdrawal, hopeless
  •   ~  Depression, despair, resignation, ambivalence,
  •   ~  Non-responsiveness, confused or disoriented, suspicious
  •   ~  Implausible stories, contradictory statements, hesitation to talk openly, covering up for caregiver

Be on the lookout for trouble signs. Don’t be so quick to dismiss conflicting accounts of an incident by family members, caregiver, and/or the elder victim, it may be more than forgetfulness or paranoia. There might be trouble if the caregiver or family member isolates the elder person and won’t let anyone into the home or allow them to speak to the elder. There might be an underlying reason that a caregiver is being verbally aggressive or controlling, or acting overly concerned about spending money.  

A caregiver is more at risk of being an abuser if he or she:

  •   ~  Depends financially on the senior person or elder
  •   ~  Suffers from alcohol or substance abuse, mental or emotional illness, health problems
  •   ~  Was abused as a child, grew up in a household where violence was used to resolve disputes, or has a history of conflict with older persons
  •   ~  Is experiencing stresses such as marital conflict, unemployment, economic problems,
  •   ~  Is a caregiver lacking activities outside the home while caring for both parents and children
  •  ~  Suffers from low self-esteem, has little experience or skill as a caregiver, does not understand the elder person’s disease, has little support from other family members, or unrealistic expectations about being a caregiver.

If you are responsible for an elderly loved one or senior family member, be sure to tell them that NO ONE has the right to hit you, hurt you, humiliate you, or hack your finances!

Anné Desormier – Cartwright reminds us that exploitation means, “That a person in a position of trust knowingly, by deception and intimidation, obtains and uses or tries to obtain and use a vulnerable person’s funds, assets, or property. This includes failure to use the vulnerable person’s income and assets to provide for the necessities required for that person’s care.” Be wary of a caregiver that has control of a senior’s money but is failing to provide for their needs or is pushing for a vulnerable senior or elder to sign over assets or property or give them Power of Attorney. To avoid financial exploitation, seniors and the elderly should:

  •   ~  Use direct deposit for check payments due
  •   ~  Never sign a check and leave it blank for someone else to fill in
  •   ~  Never sign anything they don’t understand and be aware of scams
  •   ~  Refuse to give any caller a credit card number or other personal identification
  •   ~  Not be afraid to hang up on telemarketers!
  •   ~  Never give anyone their ATM access code, and cancel the ATM card immediately if it is stolen
  •   ~  Check their bank statements often making sure there are no unauthorized withdrawals

We should all be angry at crimes against those easily taken advantage of.  We cannot look the other way or justify the actions of an abusive relative, even if we fear what the justice system will do a family member. Instead of remaining silent, we must support advocacy for the vulnerable seniors and elders in our community. Remember, seniors and the elderly can remain anonymous in reporting, just as you can with any crime. Most elder abuse hotlines are staffed 24/7.  Anné Desormier – Cartwright urges us to, “Do what we can to educate ourselves, and encourage others to report elder abuse.”

Elder abuse has elicited great concern in the Florida legislature, so much so in fact that recently Governor Rick Scott proclaimed June 15th “Elder Abuse Awareness Day”. Click here for: Florida Statutes on abuse, neglect, and exploitation of Elderly Persons and Disabled Adults: http://www.leg.state.fl.us/statutes Click here for other resources: http://www.agingcarefl.org/

Contact Us: Regal has RNs, LPNs, certified case managers and clinicians that can perform a comprehensive assessment should you fear your elder loved one is not properly being taken care of whether in a facility or at home. We can assess medication management, track and report changes or overall decline, identify situations where additional treatment is needed, provide solutions if an upgrade in care is suggested and whether or not the environment is safe. For more information, contact Regal’s Founder, Ferial André, RN, CCM, CDP, CAEd, at 561-499-8382 or or ferialandre@regalcares.com.

Anné Desormier-Cartwright, Esq. is a licensed Florida attorney since 1985, and is currently the Managing Partner of Elder and Estate Planning Attorneys PA. Since 1994, her law practice expanded to include guardianship, mental health, probate and trust administration, and trusts and estate planning including Special Needs. Recently, she began helping clients with remedies for elder exploitation.  Appointed to the Guardianship Education Committee for the Palm Beach County Bar since 1998, Anné serves on the Probate and Guardianship Practice Committee of the Florida Bar and is a member of the Real Estate, Probate and Trust Section of the Florida Bar, and the American Bar Association as well as the Elder Law Section of the Florida Bar. She is a Charter member of Elder Counsel, and an active member of the National Academy of Elder Law Attorneys and Academy of Florida Elder Law Attorneys.  Anné can be reached by calling 561-694-7827 or adcpa@adclaw.net.

This article is not intended as medical or legal advice. The content of this article is general and should not be relied upon without review of your specific circumstances by competent legal counsel. Reliance on the information herein is at your own risk, as it expresses no opinion by the firm on your specific circumstances or legal needs. An attorney client relationship is not created through the information provided herein.